How To Introduce A New Product In Your ClinicJune 10, 2013 When an elderly couple visited Animal Hospital of Smithson Valley in Spring Branch, Texas, they complained about fleas covering their German shepherd. Dr. Roy Madigan confirmed the infestation and said, "Let’s put him on a dose of the new Frontline Tritak while we’re talking.” Five minutes later, fleas on the dog’s rear legs were seizing and falling off. By the end of the exam, they all saw a pile of dead fleas on the floor. "We decided to use Frontline Tritak for its quick flea-killing time,” says Dr. Madigan. "We also need strong tick control in our area.” Although the flea/tick category saw 15 new entrants between 2011 and 2012, manufacturers know veterinarians’ recommendations drive consumer demand. Last winter was the fourth warmest winter on record and prolonged the need for flea-and-tick products. "At the end of the day, we are all racing toward the same goal—to get more pets protected,” says Shawn Hooker, director of parasiticides long-term strategy at Merial Ltd. in Duluth, Ga. Before expanding pharmacy shelves, veterinarians need to evaluate whether a new drug meets the medical needs of their patients or fills a void, …
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Our Part In Pet Loss & GriefMay 31, 2013 In my last blog, I shared more information about the Veterinary Social Work Summit, and two of the four pillars of that master’s program at the University of Tennessee: animal-assisted therapy and the link between human and animal abuse. Next we’ll look at the third pillar, pet loss and grief. By the very nature of what we do, we are in the position to help pet owners through loss and grief. They come to us when their pets are ill or injured, whether the pet has a chance to recover, or not; or they come to us when it’s just a matter of time left for the pet, whether a day or a month. Most of us, or dare I say all of us, do this work with grief and loss without any formal training either from our schooling or our employers. We learn it "on the job,” because death is a part of our job. We may never slow down long enough to really reflect on how unprepared we are to be helping these pet owners. At the Veterinary Social Work Summit, there were presentations about …
Lasers Promote Faster, Stronger Wound ClosureMay 21, 2013 Wounds and dermatology issues represent perhaps the widest variety of ailments in veterinary practice, both in origin and complication. From an acute burn to a chronic lick granuloma, from an ischemic ulcer to a dehiscent surgical site, no two wounds will be alike. Compound this variation with different histologies and enzyme over/under-expressions; then throw bacterial or fungal infections on top of all that; now plan for a dog gnawing at it constantly or a horse sleeping in a dirty stable. Snake Bite This is a snake bite case handled by someone who was skeptical about therapeutic lasers. The dog was bitten in the hind limb and after three days, the entire belly was necrotic. Veterinarians did a full surgical debridement on Day 5 and one day later, the necrotic tissue returned to the entire area. At this point on Day 6 they applied the laser, but in the interest of science and skepticism, they left a control section, lasering two-thirds of the belly and leaving one-third untouched, above right. Two days and two treatments later, the effects on each section are clear. At …
Blowing The WhistleApril 30, 2013 On my Yahoo! home page recently, there was a story about a dentist who was raided by the health department. They found disgusting, dirty, unsterilized instruments and unclean conditions. They suspect this dentist has exposed thousands of patients to blood-borne illnesses such as Hepatitis B and HIV. I read the story to find out who tipped off the health department; apparently it was a patient that had no other risk factors and had tested positive for one or both of these illnesses. I must say, I expected to find out that someone working in that dental practice tipped off the authorities, and I must also say, I’m a bit disappointed to find out that wasn’t the case! There were obviously people besides this dentist that worked in that practice. Were THEY trained professionals, who would know the difference between "good medicine” and what this dentist was practicing? Did they know, and just choose not to tell for fear of being a "whistle blower”? By the way, "whistle blowers” have legal protection against retaliation; if you report an unsafe environment to OSHA, for example, your employer can not retaliate in any way, including terminating your employment. Although in …
Community Activities Fuel Practice Growth For David Beltran, DVMApril 4, 2013Engineer-turned-veterinarian says biggest factor in his success is volunteerism. To understand the influence David Beltran, DVM, has had on a generation of California kids, just look at Monica Trujillo. When Trujillo was in the fifth grade, her mother signed her up to volunteer at Beltran's practice, Veterinary Healthcare Service in Monterey Park, Calif. One day a week, after school, she'd show up faithfully. At first, she just cleaned tables and mopped floors. Soon, Trujillo was making labels and counting pills; eventually, she was trained in more complex tasks, such as taking patient histories and assisting during exams. The day she turned 16, Beltran hired her as a tech, a job she held through high school and college. And later this year, with more than 10 years of practical experience under her belt, Trujillo will apply to veterinary school—a dream she directly attributes to her long-ago opportunity at the clinic. Dr. Beltran is committed to serving his community, both as a veterinarian and as a volunteer. “I love veterinary medicine, and I know exactly what I'm getting into, thanks to Dr. Beltran,” she says. “I am so lucky I was able to start here as a volunteer.” Trujillo is …
How To Avoid Sticker Shock At Your Veterinary HospitalApril 1, 2013 Have you ever slapped a client? You probably have and didn't realize it. While shadowing an appointment during a consultation, I observed a receptionist at the front desk. She said, “That will be $302 today,” and slapped the client with sticker shock. “Wow! That's as much as my car payment,” the client exclaimed. Asked about price, 34 percent of clients say veterinary care is higher than they expected, according to the Bayer Veterinary Care Usage Study.1 Every team member influences perception of value. Here are ways you can turn the smack of price into satisfied clients: Schedule first, pay last at checkout. If a patient needs follow-up care, make the appointment before presenting today's invoice. Sticker shock may cause the client to hesitate to come back, assuming she'll pay the same $302 next time. Because the veterinarian wants to see a dog with a skin infection again in two weeks, the receptionist should say, “Dr. Olson needs to see your dog in two weeks to ensure the skin infection has healed. That would be Feb. 22. Does this same time work for you?” Direct the client to a specific …
Pet Insurance Myths DispelledMarch 29, 2013 There's a lot of information out there about pet insurance, but there's a lot of misinformation, too. Pet health insurance is on the rise, growing tenfold over the last 10 years, according to the Better Business Bureau, from one pet insurance company in 1997 to 12 companies in the United States today. And with roughly 1 percent of U.S. dogs and cats insured, compared with one-fifth of pets in the United Kingdom, the industry can expect that growth to continue, according to BBB. Despite the optimistic outlook, one of the most common myths that plagues the pet insurance industry is that it will turn pet care into HMO-type healthcare to which humans are subject. Kerri Marshall, DVM, chief veterinary officer for Trupanion in Seattle, Wash., said she doubts the changing world of pet insurance will leave pet owners navigating HMO-like mazes and rules. “Understandably, veterinarians don't want to see pet insurance providers controlling the way they price,” Dr. Marshall said. “This concern comes from these veterinarians' interactions with pet insurance providers who reimburse based on benefit schedules. They see that these providers are reimbursing only a portion of the price they charge, saying that the …
6 Things Learned From Other Veterinary SpecialistsMarch 28, 2013Even specialists can learn a lot from each other. I recently talked to an infectious disease specialist and an anesthesiologist to find answers to some common but tough questions. 1. Implants and UTI Say your patient has had a TPLO, or a fracture repaired with a plate and screws. A few days, months or years after the surgery, your patient has a urinary tract infection. How worried should you be about surgical site infection (a.k.a. SSI)? Scott Weese, a board-certified internist turned infectious disease specialist at the University of Guelph vet school (Canada), says that the risk is probably not too high. We don't have clear evidence that dogs with UTIs are likely to become bacteremic, which would be the main route of UTI-associated SSI. Having an opportunistic pathogen in the bladder probably doesn't constitute that much added risk because the bacteria would be dwarfed by the large populations of commensal flora containing potential pathogens in the gut, skin and other locations. 2. Implants and MRSA Would Dr. Weese's answer change if the culprit were a methicillin-resistant bacteria? In the case of an active or recent methicillin-resistant staphylococcus aureus or staphylococcus pseudintermedius, or for that matter, any other concerning multidrug resistant …
The Bigger Person And Customer ServiceMarch 21, 2013 Now I'm not one to usually complain about the customer service I receive out and about … well, I don't usually complain to the person or boss of the person who has treated me rudely; I may complain to anyone else who will listen. In general, I'm pretty easy going. Yet when faced with someone I feel is rude every time we interact, the same person at the same place that I frequent, is a bit much even for me. So this person acted rude to me the other day, and I was quite miffed. So miffed, that some thoughts went through my head such as, “I'm gonna tell her boss that she is always rude to me,” or “I'm going to ask her coworker what her name is, and what her PROBLEM is … ” and somehow make my feelings known. Then I thought about the rude scenarios, and realized that unless I could very clearly represent the TONE of her voice when she said what she said, no one else would “get” how rude she really was. …
Self-test: What Kind Of Person Are You?March 19, 2013 Tasha, a 9-year-old female golden retriever, needed surgery to remove a thyroid tumor. Although the tumor was richly vascularized, surgery went well and Tasha recovered nicely. However, a few hours after surgery, Tasha became dull and less responsive. Her breathing pattern was very odd, a strange combination of inspiratory and expiratory effort. A few hours after waking up, she arrested. CPR was unfortunately unsuccessful. A tumor thrombus or a blood clot to the lungs and/or the brain was suspected. Of course, I called the owner to offer my condolences. A week later, I mustered enough courage to call the owner, a physician, to check on him. I had spent a lot of time with him and answered multiple questions during the consultation, so I probably developed a stronger bond than with most clients. He was very understanding, and knew that sometimes things go wrong even though everything was done right. The owner shared a concept that I have never heard before. Surely you have heard the ultra-classic quote, "People don't care how much you know, until they know how much you care." Well, here's a twist on that quote, courtesy of Tasha's owner. According to him, …
